States Deal with Possible Pandemic

By Mary Branham Dusenberry, CSG Managing Editor

That growth in cases, as well as in the number of counties where they’re located, has state public health officials planning for the next step.

“The phase of response we’re in now is case finding,” said Dr. Bonnie Sorensen, chief deputy director of the California Department of Public Health. “We are spending a lot of time and resources investigating each individual case, interviewing each of the contacts and monitoring those folks very closely.”

The state has confirmed 14 cases of swine flu as of Wednesday afternoon. At some point, Sorensen said, the state will shift to addressing what more needs to be done in the community. It’s a phased response to the problem.

“Infectious control is not a sprint,” she said. “It’s more of a marathon.”

Sorensen said the swine flu outbreak could last another six to eight weeks, but assured reporters during a press conference Tuesday afternoon that the state is ready to respond. The World Health Organization issued a phase 5 alert that swine flu may reach pandemic levels. Level 6 is a full pandemic outbreak, meaning a global epidemic, according to WHO.

California is one of 11 states that have confirmed human cases of swine flu, according to the Centers for Disease Control and Prevention.

As the number of cases balloons, states across the country are assessing their preparedness levels.

“We are developing capacities to do further response … We feel like we have developed the capacity here to face exactly this kind of challenge,” said Dr. Mark Horton, director of the California Department of Public Health.

In Texas, where 26 cases have been confirmed including one death as of Thursday, the state is “doing aggressive surveillance” of any illness diagnosed as flu, said William Ayres, a spokesman for the Texas Department of State Health Services. As in California, Texas is in the diagnosis phase. Ayres said the state has issued precautions asking people with flu-like symptoms to stay home. On Wednesday, the state postponed public school athletic and academic competitions because of swine flu, The Associated Press reported.

States are using past experience—when they established plans to deal with Severe Acute Respiratory Syndrome, or SARS, in 2003 and with the avian flu threat in 2005—to deal with the current crisis, according to Stateline.org. In addition to ramping up surveillance of people with flu-like symptoms, some states have closed schools where cases have been confirmed and are working with local health departments and health care providers to promote commonsense ways to prevent the spread of the disease. They’re also stockpiling anti-viral medications like Tamiflu.

While plans are in place, state budget problems may hamper the most effective implementation, according to Sujit CanagaRetna, senior fiscal analyst for The Council of State Governments’ Southern office, the Southern Legislative Conference.

“When you have the kind of shortfalls states are facing, it’s inevitable that state health departments are going to take cuts, and they have been,” he said.

In addition, he said many states are losing experience in the public health area. Some 1,500 jobs in public health across the country were lost between July 2008 and January 2009, CanagaRetna said. Another 2,600 in those departments are expected to lose their jobs by this summer.

“In terms of concrete terms, what this means is that we lose the capacity or the ability to act fast in an emergency because you’re going to be short staffed,” he said.

That hasn’t happened in California, according to Ronald Owens, a spokesman at the Department of Public Health. While the governor proposed a 10 percent cut of staff positions, the health departments are still able to meet the challenges posed by swine flu.

States across the country are taking action.

In Massachusetts, public health officials are testing several flu cases among people who recently visited Mexico after two Bay Staters were confirmed with the illness, according to the Boston Herald.

In Virginia, the state’s Department of Health is stockpiling anti-virals and asking health care providers in the state to “have a high index of suspicion” about influenza-like illnesses, according to a department press release.

In Wisconsin, health officials are stockpiling anti-viral medications, according to American Chronicle. Three probable cases have been reported there.